A study into the association between alcohol consumption and suicidality among the adult Hong Kong population

Abstract

Introduction Suicidality and excessive alcohol use are both important public health issues. Various risk factors including alcoholism have been studied and identified to be associated with suicidality. Increasing evidence has shown that excessive alcohol use is associated with a wide range of physical and mental health issues. There is a lack of local study to study the association between alcohol consumption and suicidality in details including the association of different patterns of alcohol use with suicidal thoughts and behaviors. The aim of this study is to study the association between alcohol use and suicidality, taking into account of possible differences between different pattern of alcohol use and various possible confounding factors.

Methods This study was based on analysis of data collected in Population Health Survey (PHS) conducted in 2003/04, which was conducted by the Department of Health (HKSAR) and the Department of Community Medicine (HKU). A total of 5600 respondents between the age of 18 to 64 were included in this study. The primary outcome was current suicidal ideation. Association between history of suicidal attempt with the other variables was also studied. The primary predictors variables included alcohol-related variables (presence of drinking, age of first drink, type of drink, amount of drinking, presence of binge drinking), history of mental illness (self-reported known history of depression, anxiety disorder and schizophrenia), level of depression and anxiety (STAI and CES-D scores), quality of life (WHOQOL-BREF score), exercises, stress management and various demographic variables including age, sex, place of birth, marital status, education level and income level. Logistic regression was used to analyze the association between suicidality and alcohol use.

Results The prevalence of lifetime history of suicidal attempts is 5.1% in this population. 17.3% has lifetime history of suicidal ideations, 1.3% has a suicidal attempt in the past 1 year and 11.9% have suicidal ideations in the past one week. Being divorced or separated, being female, being a smoker, considering themselves having need for emotional support, having more severe depressive symptoms, having chronic diseases, depression and anxiety disorder were associated with presence of a history of suicidal attempt. The presence of current suicidal ideations was found to be associated with more severe depressive symptoms, poorer quality of life as reflected by a lower physical domain score of WHOQOL-BREF, being single, having history of binge drinking, having recent suicidal thoughts and lifetime history f suicidal thought. The presence of alcohol drinking and larger amount of alcohol intake were not shown to be significantly associated with presence of suicidal ideations and behaviors in the binary logistic regression models. Only the association between presence of current suicidal ideation and binge drinking was shown to be statistically significant.

Conclusion This study did not find a strong association between alcohol consumption and suicidality. Among the alcohol-related variables, only binge drinking was found to be statistically significantly associated with current suicidal ideations. Further study to further explore association between alcohol and suicidality should be considered.